“A Little Bite Won’t Hurt”: The Failure of Moderation

One of the biggest problems I had with the nutrition education that I received during my path to become a registered dietitian wasn’t the low fat, high carb recommendations. I was fully prepared for hearing that stuff. Instead, it was the “everything in moderation” approach to weight loss counseling that I had the biggest issue with. We were taught that unless you told people that no foods were “off limits” and that all foods are healthy “in moderation,” you could be doing people a disservice.

The problem is, people don’t want to hear the truth…

I think this mentality largely comes from the fact that many dietitians are themselves recovering from disordered eating. My instructor, while drinking her diet coke in-between powerpoint slides, would tell us how limiting food groups could lead to “orthorexia” and this led to an eating disorder. I remember raising my hand and saying, “Don’t you think a certain level of orthorexia might be important in our modern food landscape with hyper-palatable foods everywhere we turn?” The entire class gasped and stared at me. I hear whispers among the students. This challenge to what we were being taught was blasphemy. I would clearly induce anorexia by suggesting someone avoid processed sugars. My professor stood behind her statement.

Someone recently told me she had bariatric surgery a few years ago. Clearly the moderation thing is working for her.

People going on crash diets often gain the weight back. Frustrated with this, many are gravitating to the “everything in moderation” theory, and simply trying to maintain their weight. This is supported by dietitians, our government’s advice and by the food industry (of course)!

Chick-fil-A’s to-go paper bag suggests that you “Stay Balanced” so if you splurge during the day, balance it with more exercise. Oh, and eat their 8-count chicken nuggets every three to four hours.

Source: http://www.timesrecordnews.com

A new study, published in the journal Appetite, illustrates how “moderation” means different things to different people. The researchers hypothesized that people’s own food preferences would have a huge influence on what they consider “moderation.”

When considering their own food intake, people like to “favor themselves” and are notoriously poor judges of how much they’ve just consumed, both in volume and in calories. They can’t seem to remember what they just ate, but often feel that they’re doing well with their food choices, regardless of their weight.

Proving their hypothesis, the researchers found that the more people consumed of a particular item, the larger their sense of “a moderate amount” was. Furthermore, people tended to view their own consumption as “better than moderate.” Meaning, what they ate was less than what they consider a “moderate intake.” This was regardless of their BMI, so both healthy and obese participants answered the questions in a similar manner. (Yes, I know that BMI isn’t always the best marker for health.)

The University of Georgia’s Michelle vanDellen, an assistant professor in the department of psychology, led a study that found that the more people like a certain food, the more forgiving their definitions of moderation. Credit: Dot Paul/University of Georgia

“These results suggest people evaluate their own consumption as moderate. If anything, people seem to define moderation as greater than their current consumption, indicating that they do not actually think of it as limited consumption of an item. Moreover, definitions of moderate consumption are related to levels of personal consumption: the more people consume of a food or beverage item, the more of that item they consider to be moderate consumption. In contrast, people’s perceptions that they consume an item moderately were unrelated to the amount of each item they actually consumed and the amount of that item they consider moderate… That is, people may implicitly endorse their reported consumption as appropriate because the typical amount they eat is less than what they define as moderate.” The researchers concluded.

Additionally, in “Better Than Before,” author Gretchen Rubin describes how moderation usually fails most dieters, but also mentions that most nutritionists are moderators. Her book is a fascinating look into what motivates people, and what works in order to change habits. If you haven’t already read it, I recommend it highly.

A few months ago, I was allowed to sit in on an Overeaters Anonymous meeting, to learn what they were like. It was really eye opening. People were describing how they would go to the store and buy cake mix, bake themselves a cake, and then EAT THE WHOLE THING. Others would talk about how they would have to take the junk food in the house and toss it in the garbage, then cover it with water so they wouldn’t go back into the garbage, dig it out, and binge on it. One woman reported that her car was her “vehicle” and that she could never make it home from the store without devouring and entire package of cookies. You know what worked for all of them? Abstinence. Nearly all said they were only successful when they cut out wheat and sugar, which were “trigger foods” for them.

The more I work with people, the more I realize that people are looking for clear answers. Most people really like to hear, “eat this, don’t eat that.” This is why paleo works as a weight loss tool. The reason why people sometimes gain weight following their 30-day challenge is because 80/20 is very hard to self-regulate. I’ve noticed it quickly becomes 60/40, then 30/70. I personally am blessed to have Celiac disease, because I am automatically abstaining from a large group of foods that most people have no “off switch” for. Sugar doesn’t really do it for me – but salt does! I know that I can’t go near potato chips and even gluten free pizza can be an issue for me.

It’s also completely NOT YOUR FAULT that certain foods can trigger overeating. Our brains are designed to seek out calorically dense foods. During our hunter-gatherer times, berries were hard to come by, so our receptors are highly stimulated by sweet and or salty foods. That’s what kept us alive. Today, however, our brains have not caught up to our modern 24/7 access to junk food. This food bypasses our normal satiety signals and we can’t help but overeat it. The only solution is to develop a mild form of orthorexia and eliminate certain foods from your lunchbox, pantry, diner plate, and dessert tray. If you know that you can’t have just one bite of ice cream, then it’s probably not a great idea to keep it in your house.

A note on paleo treats like cookies, brownies, cakes and everything in that category: I don’t have an issue if people eat them, but please don’t consider them in your first 30 days if you’ve had issues with overconsumption of hyper-palatable foods. A paleo brownie is still a brownie. If you’re trying to reset your palate, then do yourself a favor and abstain as you’re getting used to eating “normal” foods like meat and veggies. I don’t keep baked goods in my house, I don’t “bond” with my kids over making cookies, and I advise my nutrition clients to do the same.

Now, if you’re in the 1-4% of Americans that happens to have an actual eating disorder that requires you to view “everything in moderation,” I’m not speaking to you in this post.

Maybe you’re one of the few healthy, successful moderators. If so, great. But if you’re in the position of giving out nutrition advice, then it’s time to reconsider the “everything in moderation” stance, as it’s likely going to fail the majority of your clients. I know for many of my nutrition clients, if I tell them “a little bite won’t hurt.” they would eat the whole damn pie.

Diana Rodgers, RD

Diana Rodgers, RD, LDN, NTP is a real food nutritionist living on a working organic farm. She's the author The Homegrown Paleo Cookbook and produces the Sustainable Dish Podcast. She conducts one-on-one nutrition consults via Skype and at her office in Concord, MA. She also speaks internationally about health and sustainability issues in the food system. www.sustainabledish.com

Comments

This made me think of a podcast I listened to recently describing addicts as great ‘reward appreciators’. That phrase really shed a new perspective on addiction for me. As someone who can be quite obsessive and over indulgent, eliminating food groups entirely really saved me. I think if you have this type of obsessive personality, trying to dampen it or ‘moderate’ won’t work as you’re not just trying to change a habit but trying to trying to change who you are. Plus, doing so is quite sad because all that obsessive energy channeled into healthier pursuits could give way to great things!

Excellent post and completely agree…especially about the paleo treats. I think they are still triggers for some people. Cutting out grains and sugar changed my life. Weight has never been a problem, but I had horrible skin, and later digestion issues from all the antibiotics, and anxiety. I cut out the grains and sugar (and in my case, dairy) and not only did my skin clear up super fast (after over THIRTY YEARS) but the digestion issues and anxiety went away too. Call me orthexic if you want…I know what works for me.

Good article and I agree. “Moderation” has never worked for me. If I do want a “forbidden” food, I buy it out when at a restaurant for dinner. That puts in the realm of social, and a treat, and I am going to sleep soon so can sleep through the inevitable screaming from my brain for more. I even eat fruit, not forbidden, as dessert so I can go to sleep during the sugar response.

As a psychologist specializing in eating disorders, I think a balanced conversation on this topic is so important. So yes, maybe 1-4% of the population is diagnosed with ED’s, but there are so many more individuals that exhibit disordered eating and dieting patterns that are not represented in the clinical statistics. And often rigid nutritional advice and dieting based on food group restriction is a contributor to the development of concerning eating patterns/disorders. I have worked with many patients who have felt trapped by rigid thinking – only raw, vegan foods are okay or only paleo is okay or only eating x amount of calories a day is okay or fat is the enemy or carbs or [insert food]. Then when an off-limits food is eaten, the distress is overwhelming. And these patterns often start with a diet. Even in a sub-clinical population, people can experience pretty significant rigidity around eating, obsessional thinking about food, exercise, and the body, catastrophizing fear about what will happen if a fear food is consumed, and destructive behaviors due to food shame/guilt. I think that advocating balance is important – striving for healthy eating while also not demonizing any specific food groups. And that is very different from having Chick-fil-A every day.

Mimi-
Really appreciate the input but i have a bit of a bone to pick with the ED scene. From this perspective EVERYONE is eating disordered. Yet in the general population people consistently benefit from some kind of lane lines to remain within. Why do both paleo and vegan approaches work? they LIMIT food and palate options. It is the limitless palate options which allow us to bypass the neuroregualtion of appetite and thus overeat. ED’s are clearly an important topic but our diabesity epidemic is poised to destroy our healthcare and economic system due to the cost and burden. From a triage perspective I’ve got to focus on what take down our whole system.

I have myself dealt with having anorexia and bulimia for some years now. I can’t say I am cured, bc you really never truely let it go. I am currently working towards a BS in Health and Nutrition. I have several (not all) professors that are exactly as describe in this article. They are and the rest of America are insightful to watch to see how people really do treat food. I do believe everybody has some form of ED. I rarely see moderation work for anyone. Through my course work I’ve been learning the science behind what food/nutrients do in your body. This knowledge actually has helped get over my ED. I learn food is basically nothing more that a mix a things processed by the body to either improve or degrade the body (food is not a living entity with power and control as I felt before). The other part that has helped me is to limit my foods and fasting. Why does this help? Because when you have an ED you constantly feel pressured. When you simply remove a choice there is no pressure. I don’t have to pick what to have for breakfast because I don’t eat it. This is not anorexia, it’s a way to let me body rest. Then by knowing for myself I don’t eat sugar, processed foods, etc. but do eat meat, veggies, etc. I can now eat foods and not dwell on them forever. To achieve anything you must have limits/guidelines/rules or you will be scattered all over the place and accomplish nothing and feel defeated. What I including in this reply is very abbreviated bc you can’t write forever on these things, so yes more goes into my thought processes, but this is my basic MO. So being a student working towards a wellness career (bc I honestly want to help people) and having/had ED this article was amazing to read and I know the importance of being told no (even by yourself) and that allowing a little means you’ve allowed the whole damn thing.

I agree, Robb. And I have to admit that while so far the Keto diet is working for me, I have to wonder why Jimmy Moore gained all (or most) of his weight back. Is he overeating? Not practicing moderation? If he stayed in Ketosis all this time then what went wrong?

I think there’s another perspective where limiting food groups is not just demonizing foods. Any nutrition advice/ education should be taught in relation to the client so they learn about their bodies and how food/food groups affect them. Sugar is bad for me because it sends me on a bender. I’ve learned that it is a kindness to not eat these foods. It is also a kindness to accept the body I have- that goes on benders when concentrated forms of carbohydrate are consumed. I’ve also learned to relate to slip ups in a different way that befriends shame. I pause and ask, “What was that about? What can I do differently next time?.” or I tell myself, “It’s ok, you can start again now.” I share this perspective because when you are dealing with shame, the diet may be the trigger but it’s not the root cause and to perpetuate “moderation of all foods for all people” does a disservice to our clients.

I believe there is a certain strength behind the eat everything in moderation approach. I was fairly strict about eating paleo, but pancakes for breakfast every once in awhile is really delicious. I really do think the everything in moderation approach is dangerous due to the grossly high levels of terrible food we have readily available for us. You cannot find a sliver of nutrition at a gas station. The majority of food at supermarkets is processed and filled with corn syrup and sugar. Fast food is a nightmare. People need to wake up and eat whole foods. Our system is a joke, and half of it is because no one knows how to take care of themselves in the face of endless supplies of coca-cola, snickers bars, and big macs.

You specialize in the ED population. I’m talking about people who are overweight and are food addicted and CAN NOT moderate. Did you read the study? You should read the study. Because if you read the study, then you’d understand that the majority of people out there have a very warped sense of what an appropriate serving is, and think they’re doing just great, and that moderation is “more than” what they are currently eating. I also have a part in here where I very clearly state this is not for people with an ED. I made a very specific call out to that.

Eating disorders include people with binge eating disorder, i.e., people who are overweight, food addicted, and who cannot moderate. In fact, binge eating disorder is the most common of eating disorders in the U.S. population. So it is likely that the people you are talking about actually have an eating disorder, an undiagnosed one. The 1-4% statistic is quite an underestimation, given how many people with eating disorders remain undiagnosed due to stigma. But that’s a different conversation.

Going back to people who cannot moderate and are addicted to food. Not all of them, but quite a few among these folks may have binge eating disorder. From what we know from the psychology of these illnesses, advising elimination of certain foods may likely have a boomerang effect. There are so many writings from people who have had an ED or who have treated tens/hundreds of people with ED on this matter. Let’s listen to them.

And this is why we should listen to them. I am a social scientist studying individuals’ perceptions of EDs and people with EDs. And what I have found repeatedly, regardless of how I look at the problem, what I show participants, how I ask them the questions, is that there is a huge gap between the reality of these illnesses and how people see them and how they see people who have them. And that is why I believe we should listen more to people who actually know what EDs are, first hand.

Now going back to moderation and it not working and to how orthorexia might be a better alternative. Orthorexia is a recently coined term at the NIMH and not much is known about it yet. However, it is believed to be part of the EDs family. It sounds good on paper though – avoiding unhealthful foods, etc. However, it is likely to evolve into a full fledged illness, characterized by obsessive thinking, restricting, along with other comorbidities, such as depression and anxiety. There is no “a little” orthorexia, the same way there is no a little anorexia or bulimia. There is no moderation in these illnesses, there is no “I can stop, I will stop”. These facts should not be taken lightly. They have been verified by quite a few decades of psychiatry and psychology research. Any eating disorder is a trap you don’t want to be in – the amount of physical damage and mental pain are not worth it, not for any amount of sugar or fat that doesn’t get into your body.

What do we do then if moderation and a little orthorexia both fail us? We educate people. We restrict the food industry a little more. We can’t do the latter, the FDA is working on that, but we can do the former. It is the only viable, long term, sustainable solution.

I am not saying that the restriction you mention might not work for some people. It might, with healthy, balanced individuals [however, it is unlikely that the overweight, food addicted, cannot moderate people you mention are them]. However, if you blame the moderation rule, then perhaps restriction should not become a rule either. What should be the rule is listening to each individual and, in conjunction with other medical professionals, understanding what it is best for them. If EDs are a concern – binge ED, Anorexia, Bulimia – than solutions other than restricting/eliminating certain types of foods might be better. And not because the elimination of those foods is not the right choice, but because of what the idea of eliminating/avoiding some foods does to the person who has ED tendencies.

I stated very clearly that this is not for those with disordered eating or eating disorders. I also know that from what I saw at the OA meeting, restricting trigger foods seems to work for everyone in the room (25 people), and is the motto of OA. So, for those who already restrict and turn to a diet like paleo to restrict further, then this is obviously not a good plan for them. However, the “everything in moderation” approach seems to be failing the majority of humans who are addicted to food.

Hits home for me. I struggle with what I would characterize as food addiction. I have recently been dignosed with Type 2 diabetes. This shines a light on how this addiction is real and can manifest itself in serious health issues. The ONLY thing that works for me, is a fairly strict Paleo diet with little or no simple carbs and Lots of green veggies. Moderation for me turns to binge eating and a state of perpetual “failure”. Thank You for reminding me!

Great article and I think moderation doesn’t work when the foods are designed to make you eat more. Food scientists make their living on getting the perfect combo of salt, fat, and sugar to keep us wanting more. We think we can beat that with willpower alone I am not so sure.
I was surprised to see a presenter at Paleo fx talk about how food moderation works. It just not something you see in the space especially since we are not eating grains, legumes, dairy, and processed sugar. (or whatever variation works for you individually)
I think for a majority of people it just doesn’t work. I have helped my friends and family switch their lifestyle and if food is in the house they will find it and eat it.

I identify so much with this article… Moderation doesn’t work for me. I want it to, but it doesn’t. In turn, I beat myself up because I can’t do it, and what better way to do that… Food! Trying to work my way back to the way I should be eating.

The kind of eating pattern that works best for me (one that helps me achieve optimal weight and makes me feel better) is one that says, “Eat these foods and avoid those.” I do not do well on an “all things in moderation” diet. Thank you for this article!

This blog post really resonates with me. Trigger foods do me in, and can start a binge that goes on for weeks. (or longer). Yes, even one bite. I consider my own sugar addiction to be similar to alcoholism, so I wasn’t surprised to read that alcohol and sugar are metabolized similarly. Thank you for this post!!

This is a great article. I had a disordered relationship with food for most of my life and one thing I found so frustrating in trying to heal my relationship with food is the “everything is healthy in moderation” message. Several family members have/had diabetes and severe IBS (me included with IBS) and I just couldn’t wrap my head around the idea that allowing myself to eat WHATEVER I wanted “in moderation” was going to make me healthier or happier, because that didn’t seem to be working for anyone around me. It wasn’t until I cut out hyper palatable foods that I realized I don’t actually have a problem with “moderation” and cravings, but the primary drivers of overeating for me were grains and processed sugar consumption.

Thank you thank you. A couple of things; watching a dietician try to encourage a beloved very intelligent anorexic to eat cookies full of trans fats wheat and sugar because “everything is good in moderation” I said really? this person knows far more about nutrition than most dieticians, and knows some foods are toxic. Would you recommend eating poisons or plastic in moderation? Secondly, ED literature recognises vegetarianism as a common precursor to ED. I don’t see the same pathway from Paleo, or gluten-free to ED. Thirdly thank you for acknowledging OA. That has been a huge breakthrough for me personally: identifying my own trigger foods, going sugar and flour free, eating 3 ‘normal sized’ healthy meals a day regardless of whether I feel body shame and want to eat less, or stressed and want to eat more. It’s about learning healthy eating and hunger patterns in a supported setting. And bringing a spiritual perspective into my life has released stress, fear and shame. Well done, let your message be heard loud and far.

“It’s also completely NOT YOUR FAULT that certain foods can trigger overeating. Our brains are designed to seek out calorically dense foods.”

If it is calorically dense foods that are the problem, then we should be eating only less dense food, and avoiding fat, which is the most dense of all. Yet when hunter gatherers (and also city dwellers like myself) eat primarily fat, they remain healthy. So caloric density is not the issue.

Lots of foods are calorically dense, only some cause more problems than others. Obviously you are pointing out that fat doesn’t make you fat. However, I’m sure you’ll agree that when you combine fat with sugar, refined wheat and salt, then you’ve got a potentially big problem. Eat that stuff daily “in moderation” and you’ve got type 2 diabetes brewing. Calorically dense doesn’t equal nutrient dense. That’s where the issue lies.

It is confusing to say that the problem lies with calorically dense food and that the problem actually lies in its combination with sugar, “refined” wheat (in my view all wheat is the problem, not just the refined stuff) and salt (salt is not an anti-nutrient). And this is really another of the problems with nutrition advice–I agree that calling for moderation is a problem. If I eat moderately carbs with moderate fat I will be hungry all the time. But if I eat copious fat with vegies and meat while avoiding carbohydrate, then it curbs my hunger. There is absolutely nothing moderate about my diet and I am eating very dense food (with “calorie” density and high nutrition).

If you had avoided the term “calorie”, I would have been able to share your post because you make some good points. But by adding that term, you confuse the issues. It is carbohydrate that is the primary driver of cravings and thus the main culprit in obesity. Fat, while calorie dense, is not the main culprit at all.

If what I am saying, that fat is not the problem, and indeed lean hunter gatherers eat a lot of fat when they can get it (e.g., Inuit), then to be methodologically consistent, we shouldn’t blame the calorie density of food, but rather the effect that food has on the metabolism, especially as it affects cravings.

yes but we are programmed to seek out CALORICALLY dense food. Not nutrient dense food, necessarily. That’s the PROBLEM. I am not sure you understand what I’m saying. Our bodies want calories. The brain doesn’t care how the calories come, but the tastier the better. This is where the engineering of food becomes a big problem. We don’t crave lettuce, we crave processed crap because it’s calorically dense and hyper palatable. Yes, there are some calorically dense food that is also nutrient dense. This is what SAVED us as hunter gatherers. Fat, as you say, is calorically dense but also happens to be good for us. Do you get what I’m trying to say? Hunter gathers were not TRYING to be lean. Some of us today are trying to be lean, so we look for nutrient dense food instead. I think we’re in agreement here.

Thank you for this article, I really identify. I am recovering from Bullimia, I am in OA and I am studying to be dietitien. I started my course challenging my professor, but now I have given up..basically I was told that if any of my views became apparent in the oral exam ( I am studying in France and we have a 45 minute oral), I would not pass….so mouth shut until I qualify!!!

“People were describing how they would go to the store and buy cake mix, bake themselves a cake, and then EAT THE WHOLE THING”

Ahhh, the good ‘ol days! With a whole tub of frosting of course. I always found I did better this way. Just eat the whole cake, wake up the next day and make the hugest poop of my life, tip the scale a little heavier and move on.

If I tried to eat it slowly, I would eat a bowl full each night & it would become habit very quickly. Wow maybe moderation does suck!

Excellent article, thanks so much! The “things in moderation” has always irritated me as I’ve noticed the same thing; people who abstain tend to remain on a balanced diet while people who moderate tend to lean further and further into eating foods that create the health consequences they are trying to avoid. (I don’t work with people with ED so of course I exclude that.)
Gretchen Ruben also has a podcast and she follows up on the abstainer versus moderator idea. She’s shifted her position to moderators actually being abstainers who haven’t learned to reframe (freedom from fries versus denying yourself fries). I’ve seen the same thing in self-declared moderators I’ve worked with who happily become abstainers after learning reframing techniques.

“Everything in moderatation” is rarely a good strategy IMO.. Highly processed, hyper-palatable food are addictive.

You don’t tell someone who is addicted to alcohol or drugs that he can have a beer or some heroin every now and then, so why would you tell someone who is “addicted” to sugary, junk foods – which tap into many of the same areas in our brain as addictive drugs – that he can eat cake and drink soda, as long as it’s done in moderation..?

People want to hear that it’s okay to eat everything in moderation and get 15-20% of their calories from junk food; because this is the comfortable route.

They don’t want to hear that they should go strict Paleo for 30 days or completely take junk food out of their diet; because this is difficult and requires willpower, at least in the beginning.

Some people read about diet and health online not because they want tips on how to change their diet, but rather because they want to find articles and science that tell them it’s okay to keep doing what they’re doing.

I’m all about MINDFUL EATING, but the fact is, when we say “everything in moderation” it simply FAILS PEOPLE. Most dietitians are moderators, so they tell others to moderate too. This “no foods are bad, you just need to listen to your body” mentality simply doesn’t work for most people. There are real food addicts out there, and many modern processed foods are DESIGNED to bypass our natural signals of satiety. I’m sure you know people who can’t stop at one chip. How many chips are a “moderate” amount of chips? This all depends on how much you enjoy eating chips, according to the science. So, perhaps you are a great moderator, however if you’re in the business of helping others find “balance” with their diet, then simply telling them to be mindful, stop stepping on the scale, and to “listen” to what our bodies need is not going to help everyone. What about the people whose bodies are crying for sugar? Their bodies are telling them to eat more sugar. Should they listen???

Have you not heard of habituation. Did you read the rebuttal article that unravels the study you are basing this article on? What I am hearing you say is actually not based in research. This moderation research would actually have people believe that they cannot be trusted with learning to listen to their body. If you don’t want to eat chips, don’t but don’t tell people they cannot learn how to moderate. You have no idea of the freedom associated with learning to eat intuitively. I have seen it time and time again. And your comment about orthorexia being a good thing completely and utterly is the most ignorant and irresponsible thing I have ever heard coming from an RD.

If you aren’t considering relationship with food, the impact of weight stigma and the social determinants of health in your treatment planning you contribute to the harmful dieting culture- whether you call it “moderation” or a “lifestyle” change or a diet.

Seriously missed the point of what moderation is, what it isn’t and why we need it. The food and body police (hate) movement is pretty well entrenched and has done nothing to improve physical health let alone mental health with this punitive, moralistic authoritarian and patriarchal approach (BS). Moderation along with a non-diet and HAES focused approach with support is far healthier mentally and physically for individuals, it brings awareness back to the individual and a trust of and in their own body, appetite and health. It also removes the need to be ‘managed’ by others like a naughty child. I guess that’s threatening to egocentric health practitioners and wanna-be-gurus.

Yes, this works for a very small percentage of people. Mostly for those who are nutritionists themselves. Generally though, people are much better when they abstain from foods for which they have no “off switch”.

This was an amazing read. I’m really pleased with your decision to sit in on an OA meeting. As someone who has struggled hard with every diagnosable eating disorder possible, these words hit home! I didn’t love OA off the bat, but I do think it could have helped. I certainly like the idea of abstinence.

While I have found myself being able to practice moderation, I find that it fails me as I get further into it whereas true moderation (i.e. once every month or longer) works FAR better. Getting further into restricting my diet to the foods that serve a purpose to me and fuel my body properly without repercussions (digestive or emotional) is much healthier than the obsession of binge-eating.

I’ve been that person driving to and from store to store, eating in my car, dousing my junk food in cleaning chemicals, etc. That is FAR less healthy than ‘orthorexia.’ You make a great point about that being somewhat necessary. We have to retaliate against the SAD and a moderate obsession is helpful to most people in terms of structure and long-lasting success. Thanks for such a thoughtful article!

I totally relate to the article. This “everything in moderation” just doesn’t work, specially if, like me, you are addicted to sugary food. I would never be able to eat only a couple of cookies, or a few tablespoons of the “healthy banana ice-cream”. I would happily eat the hole tray of cupcakes, if I was baking with my daughter… Things now are working because I admitted my condition and accepted the fact that I just can’t eat desserts anymore or any kind of sugar. So, to help me go through this painful process, I’m doing the Whole 30 program, and I am being successful so far. No nutrition professionals helped me with that. I researched it myself and I’m so glad I took the courage and went for it. ?

YES YES YES!! Moderation with my triggers does not work for me, nor for anyone else in my life although they won’t admit it. Anyone who has quoted the “everything in moderation” quote to me has had HUGE health issues totally caused by their poor diets. Much of our food has become so processed and altered that it now has a drug like affect on most of us. Health professionals would never tell an alcoholic or a heroine addict that those things are “OK in moderation”, but the same people ignore scientific evidence that our modern processed sugars, grains, and additives have many of the exact same effects on our brain and body chemistry.

This study explains so much about my in-laws pro moderation comments. They just didn’t seem to see any issues when I would try to explain that regular consumption of problem foods was not moderate & were very hostile towards my cutting out sugar. I even had my bro-in-law ask me once if I had heard of orthorexia, I believe as a hint that I my diet needed to be re-evaluated.
Thanks for the great article!

THIS!!! Over the last year (and 76 lb weight loss) I have come to realize that there is no place in my diet for the processed foods that Americans have come to see as normal. I can now have an “cheat-day” every month or so when social plans warrant it (although I call it a planned exception – thanks, Gretchen Rubin!). What I have really found is that for the obese and morbidly obese, moderation doesn’t work. Maybe it is the addiction issues, or obsession issues, etc., but I believe that by definition if you are significantly overweight you are unable to be moderate. If I had not restricted myself almost to the point of mild orthorexia, I never would have been able to learn how good my body feels without the pollution of junk foods. I also wouldn’t have the experience of knowing how sick I feel when I eat these foods now.

The idea that mild orthorexia is a bad thing is absurd to me. In my life, I am constantly striving to improve myself, not in a way that is negative towards who I currently am, but instead in a better version of me kind of way. It almost seems as if the everything in moderation people are encouraging folks to purposefully pollute their bodies for the sake of being moderate. If you’ve never struggled with obesity, you can’t possibly understand the exhaustive nature of attempting moderation. I can refrain from eating a cookie at a party, but if I have 1 cookie, then all of my thoughts are directed completely on whether or not it is okay to have another cookie for the entire rest of the party. That is no way to live! I can still enjoy the party every bit as much by just not having a cookie. Chances are, I wouldn’t have enjoyed it as much as I thought I would anyway!

As Gretchen Rubin explains, know yourself. You are either an abstainer or moderator.
Thanks for the great article. Was told all my life about moderation, when it turns out that it doesn’t work for me after all! Abstaining from sugar and couldn’t be happier!! Thanks to Gretchen Rubin. Again, read her book or listen to her podcast to understand. It isn’t Rocket science, folks!!

If you listen to the way Gretchen Rubin talks about food and her weight, she pretty clearly has some disordered eating issues herself, so I’m not sure she’s a great resource to be promoting for a healthy attitude towards food.

I’m a nutritional therapist in the UK and totally agree. I feel the same as you about ‘orthorexia’. Recently I also noticed rather vehement criticisms of the term ‘clean eating’ as food isn’t dirty. Well, I think some so called ‘food’ is and I can’t see anything wrong with clean eating.

I am not at all surprised at the results of those studies on moderation. So far, I have always advised clients to apply the 80/20 rule, because a) that’s how I was taught and b) I can do it (depending on what it is, a certain brand of chocolate has completely gone from my life). I no longer consume sugar, but many of my clients are clinging to Paleo/gluten-free/grain-free/sugar-free cakes and biscuits with desperation. I should really change the advice I give. Thank you!

I call it the “monkey brain syndrome” when you follow your instinctual behaviors without actually thinking about your choices. Devouring a bag of cookies on the way home from the grocery store is very monkey brained. After a stressful 9-5 at the office, downing a whole container of hummus is monkey brained when I’ve already planned a dinner. I love how the results of this study showed that people consider their behavior moderate no matter what they’re food choices or quantities were. I think this deserves a different term than monkey brain. This is more like ego brain. Everyone thinks they’re normal until they run into someone else’s form of normal…and a whole lot of WTF’s ensue.

Thanks for the article. I don’t understand how food addiction is any different than alcohol or drug addiction. Professionals would never suggest to an alcoholic that moderation is okay, yet we tell people addicted to sugar that very thing. Addiction is addiction is addiction – and abstinence is the answer.

You (and this article) are absolutely correct. The moderation theory fails EVERY time. Search out “Vicious Eating” by Kris Gunners at Authority Nutrition. It is very eye opening and what pushed me to total abstinence to lose weight. It is still a struggle every day. The law of addiction says: “Administration of a drug to an addict will cause reestablishment of chemical dependence upon the addictive substance.” That includes food.

Great article. Thank you. The moderation thing never worked for me. If there was crap in the house, I’d eat it ALL. Learning that I have Celiac as well as some intolerances on top of that was very freeing for me. Going paleo has been the greatest gift I could give to my body. I no longer binge or have out of control cravings for anything. I think clearly and have energy. My body feels good. I don’t like feeling crappy. So if restricting myself to whole, nutrient dense foods (with birthday coconut milk ice cream and paleo-style cookies a time or two per year) because I like feeling good makes me orthorexic in the eyes of RDs saying “everything in moderation,” I’ll happily continue being one sick puppy with my plate of garlic-roasted Brussels sprouts, juicy grass-fed steak, and avocado chunks.

Great article. I have friends in OA and have done amazingly well. To my thinking food addiction is really no different than any addiction such as alcohol or drugs. And its becoming a greater health risk than the others leading to detrimental diseases such as fatty liver. My question is: if someone is a binge eater but binges on caloric dense yet paleo friendly and healthy foods such as nuts? Can you abstain from some healthy foods? So then it just becomes a matter of abstaining from any triggers?

I am so excited to have come across this. I was really thinking I was the odd one out to think this way. I have never been able to ‘eat in moderation’ whatever that really means. I have only had success in weight loss when completely eliminating ‘trigger’ foods (processed food). I feel overweight people keep failing to lose weight because they are essentially trying to fit into the mold which is impossible. I try to challenge popular thoughts like this on my blog getmeoutofthebowl.com Love your work, keep it up xx

I am so excited to have come across this. I was really thinking I was the odd one out to think this way. I have never been able to ‘eat in moderation’ whatever that really means. I have only had success in weight loss when completely eliminating ‘trigger’ foods (processed food). I feel overweight people keep failing to lose weight because they are essentially trying to fit into the mold which is impossible. I try to challenge popular thoughts like this on my blog getmeoutofthebowl.com Love your work, keep it up xx

This is a good article. Informative.
Aside from that, even though I don’t have children yet, I found the emphasis on baking with your children (referring to the “bonding” aspect) a little too much for me. All I can say with this is that you live your life and I’ll live mine. Even though this is my opinion, cooking/baking is bonding and it’s an important thing for a child to learn.

Thank you! There is no halfway or moderation for me, either. I, too, will go from 80/20 to 70/30….and thought I was just a failure for having no will power. I’ve started my 30 days and am taking it one day at a time. I’ll be reading more from you, thank you again. – Cara

Excellent article – though I almost feel the need to apologize for all the people who have a problem with what you’re saying!

In grad school, I was having a problem learning. An instructor was very stern and unapologetic when she exclaimed, “What you have been doing does NOT work. So try it my way!” I have applied that to every aspect of my life I wish to improve. Perhaps that’s the question each individual needs to ask themselves?

NYTimes just posted an article last week about the over 50+ genes related to obesity and the conclusion that no one diet works for everyone. However, it included that there were successful and unsuccessful outliers in all types. While most people might find this disappointing, I was pleasantly optimistic – just need to find the diets that work for the individual?

While I have had nothing but success on STRICT paleo (and reciprocating failure on non-paleo or moderation), I find it to be the best for me. However, I wouldn’t want to stop someone from finding what works for them. I personally agree with your article completely, but I also understand the emotional charge behind battling weight loss.

God you’re so incredibly smug and ungrateful. This individual posted something in your defense, and yet all you chose to respond to was a single line with which you felt was incorrect. Not a “thank you for your support” or anything remotely along those lines. Just a “actually you’re wrong.” Ugh, yuck.

I actually like some of your opinions, but I think you’re a vile person. I’ve seen the way you interact with others on social media before, and so I know this isn’t even new for you.

Thank you so much for writing this article! I am also a Registered Dietitian with a Master’s degree in nutrition and was taught “everything in moderation” as the gospel truth. This has led to huge frustration throughout the years both with my clients and myself. It simply doesn’t work! Over the years, I became so frustrated that I eventually quit my job, because I just couldn’t take teaching a method that doesn’t work over and over again. Any deviation from this method is often seen as blaspheme among our peers, because the supposed scientific evidence points to the fact that this is the best way for people to lose and keep off wait. Wrong! It doesn’t work! Thank you for being brave enough to step out of the box to tell people the truth. I recently read Robb’s new book Wired to Eat and am following his suggestions to heal my body and my mind. Keep up the great work!

Thank you for writing this. I am a recovering sugar addict. Addict in every sense of the word. I had to get to the point and realize, “I can never have this ever again”. Sugar, wheat, white carbs. When you spoke of the types of binge eating that people did in the over eating group you visited – that was me. It was tied to emotions. Stress, or emotional upheaval lead me to seek out that dopamine surge that sugar/chocolate/carbs gave. Much like the alcoholic, who when present with a stressful situation cries out, “I need a drink”. And I had to come to the realization that not would I have to abstain from the aforementioned foods, but I had to realize that after all the food was consumed, and the dopamine had surged – nothing had changed about the situation that caused the stress and emotional upheaval. I was still left with that. Eating sugar/carbs did not do anything to solve it. So while abstinence is the answers in regards to food addiction, people that have food issues really need to work on uncovering the root cause of the emotional ties to unhealthy eating – or people will be likely to return to sugar/carbs eventually when a big enough stressor comes along.

I had anorexia and bulimia and I tried the moderation route because it was to painful to give up my addictive foods for good. It was not working and I had to accept the fact that I should not touch certain trigger foods never ever. It is hard and sometimes I feel sad but then I think about my health and it is all worthy. I am worried about children. The food industry is creating addicts. Most kids crave processed foods and have binge eating disorders. As the food industry is not going to change its strategy, people need to accept that moderation is an idea they want us to believe to keep us hooked to the foods they produce

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ROBB WOLF, 2x New York Times bestselling author of The Paleo Solution and Wired to Eat, is a former research biochemist and one of the world’s leading experts in Paleolithic nutrition. Wolf has transformed the lives of tens of thousands of people around the world via his top ranked iTunes podcast and wildly popular seminar series.

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